Inspection on 30/11/06 for Knights Grove Nursing Home

This inspection was carried out on 30th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Knights Grove Nursing Home Thomas Road North Baddesley Nr Southampton Hampshire SO52 9EW Lead Inspector John Vaughan Unannounced Inspection 09:30 30th November and 1 December 2006 st X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Knights Grove Nursing Home DS0000067659.V319111.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Knights Grove Nursing Home DS0000067659.V319111.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Knights Grove Nursing Home Address Thomas Road North Baddesley Nr Southampton Hampshire SO52 9EW Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) BUPA Care Services Kimerley Ann Cowell Care Home 56 Category(ies) of Dementia (56), Dementia - over 65 years of age registration, with number (56) of places Knights Grove Nursing Home DS0000067659.V319111.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection First inspection of home. Brief Description of the Service: Knights Grove is a large newly built care home with nursing, which intends to provide a service to older people with dementia and nursing care needs. The home has three floors each with accommodation for service users in single rooms with an en-suite bathroom. Small lounges with kitchenette facilities are available on the first and second floors and a large lounge and separate dinning room are located on the ground floor. The home has a garden and patio area accessible from the lounge and this is currently being planted to improve the appearance and screening from other buildings in the area. The home is located within a new estate development and construction with local shops and transport links nearby. Current placement fees range from £430 to £600 for residential and £750 to £850 for nursing care. Knights Grove Nursing Home DS0000067659.V319111.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. As part of this unannounced inspection the quality of information given to people about the care home was looked at. People who use services and their families were also spoken to, to see if they could understand this information and how it helped them to make choices. The information included the service user’s guide (sometimes called a brochure or prospectus), statement of terms and conditions (also known as contracts of care) and the complaints procedure. These findings will be used as part of a wider study that CSCI are carrying out about the information that people get about care homes for older people. This report will be published in May 2007. Further information on this can be found on our website www.csci.org.uk. The inspection took place over two days. The inspection spoke to service users and their family members and received verbal and written feedback from service users families in the form of face-to-face meetings, short questionnaires and telephone conversations. The manager and staff of the home were interviewed and the inspector toured the service and sampled records held in the home. What the service does well: The staff have received a good level of training and support to meet the needs of service users and service users are treated with dignity and respect. Service users have a good range of activities that continue to develop to meet service user’s needs. The home offers a balanced and varied menu to meet the likes and dislikes of individual service users and the inspector received positive comments from family members about the meals provided. An accessible and spacious home provides a pleasant and comfortable environment for service users to live and receive visitors. Family members said that they feel welcomed and staff have been very supportive. Knights Grove Nursing Home DS0000067659.V319111.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Knights Grove Nursing Home DS0000067659.V319111.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Knights Grove Nursing Home DS0000067659.V319111.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The practice of the service means that service users and their families have the information needed to make a decision about moving into the home. Service users have a full assessment to document and respond to their needs. EVIDENCE: The inspector had the opportunity to meet with service users and their family members. Due to the high support needs of service is users it would be difficult to talk to individuals about the information provided by the home however the inspector was able to talk to families about their experiences of supporting their family member to move into the home. Each person said that clear information was provided before the move including a folder containing the service user’s guide and additional information Knights Grove Nursing Home DS0000067659.V319111.R01.S.doc Version 5.2 Page 9 about the home. These folders were seen in each of the service user’s rooms and the inspector was told that this information had been very useful. Family members said that they had opportunities to visit the home before making a decision to move in. The service users guide included information on fees, general information about the home and what is provided and information about terms and conditions of residency. A separate contract is issued to privately funded service users and any changes to this contract, including fees are communicated in writing. The home has only recently opened and no changes to fees have taken place yet. Service user’s funded by the local authority have been issued with a contract from this authority and the home adheres to this contract as part of their agreement with adult services. The manager was advised to review the guide, as some information contained in this document about who can be admitted to the home was incorrect. The manager agreed that this information did not match the certificate of registration and she stated that this would be amended. Four service user’s records were examined during the visit to the home. Each of these records contained an assessment of need. This was detailed and covered daily living needs, personal care and healthcare assessments. Files also had moving and handling, risk of falls, nutritional and pressure care assessments completed. Information was also on record from care managers were placements are funded by the local authority. Family members told the inspector that they had been involved in the assessment process and that the manager and staff had obtained information from them through home visits as part of the pre-admission assessment. The inspector noted essential information profiles on service user’s records and staff confirmed that these had been completed with the service users and their representatives. The manager also confirmed that following an initial referral they visited the person to carry out a full assessment of their needs and this involves the family and other representatives of the service user if appropriate. The home does not provide intermediate care. Knights Grove Nursing Home DS0000067659.V319111.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported by care plans that document their needs and how these needs should be responded to. This will be enhanced by further focus on the development of the assessment strategies and responses to supporting people with dementia. Medication administration practices protect service users and the practices of the home demonstrate that service users are treated with dignity and respect. EVIDENCE: All four service user’s files had clear assessments of need and a care plan. The care plan contains support information covering areas of personal care, health, mobility, communication and likes and dislikes. Knights Grove Nursing Home DS0000067659.V319111.R01.S.doc Version 5.2 Page 11 A moving and handling assessment is in place, falls assessment and a general risk assessment are on file to support service users to keep safe. The files examined provided evidence of contact with health care professionals involved in the care of service users. A service user told the inspector that they had seen their GP recently and there are places that they can see visitors in private in the home. The medication practices were examined and this included looking at the storage and administration of medication. Records were up to date and completed accurately. Medication is stored securely and staff members were clear on their responsibilities. Service users families said that they felt their relatives were well cared for by the staff and they feel that they are treated with respect. A family member said that they have never had any concerns and staff have always been welcoming and polite. The inspector observed staff talking to and supporting service users throughout his visit and the support provided by staff was carried out with sensitivity and respect. Doors were closed and staff only entered after knocking and announcing themselves. The service provides support for people with dementia and the manager and head of care discussed their plans to develop the care planning process in the home to include more focused assessments of the needs of people with dementia. This would also include how to respond to these needs. This will help to give clear guidance to staff on how to support service users in making decisions about their care, establishing how people make choices and their level of understanding of these choices. Knights Grove Nursing Home DS0000067659.V319111.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users receive a service that meets their social and leisure needs and this is enhanced by a service that welcomes and encourages family contact. The practices in the home support service users to make decisions about their lives. Service users receive a balanced and varied diet reflecting their likes and dislikes. EVIDENCE: The home has an activity worker who provides daily group activities. Service users were observed engaging in these activities, which included a card game and large board game. Service users engaged positively in the activity. A regular programme of activity is developing in the home and further work is planned for service users who are less active to ensure the home can meet their needs. Knights Grove Nursing Home DS0000067659.V319111.R01.S.doc Version 5.2 Page 13 Plans stated that service users liked to watch TV or listen to the radio and the inspector observed these service users engaged in this activity. Family members stated that they are made welcome in the home and there are no restrictions on visiting. Contact details for families, friends and representatives are recorded in the service user’s plan. During the visits to the home the inspector noted family members coming and going and the home was very relaxed. The menu was provided for the inspector to see and this showed that a wide variety of meals are offered to service users. Service users families told the inspector that they are very happy with the meals provided and if they do not want what is offered they can have an alternative. Nutritional assessments and care plans to support service users with their dietary needs were seen on file. Knights Grove Nursing Home DS0000067659.V319111.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has systems in place to acknowledge and respond to the concerns of service user’s and their representatives and procedures to protect service users from abuse including training for staff are evident in the home. EVIDENCE: A complaints policy and procedure are in place and available to all service users and visitors to the home. The inspector saw evidence of this in service user’s rooms as they each have a folder with information about the service this information was given to the service user when they moved into the home. Family members said that they knew how to raise a concern if the needed to and would talk to staff or the manager if they were unhappy. Family members said that they had been given information on how to make a complaint and also said that this information was in the service user’s bedroom. They were confident that the staff team and the manager would listen them to. Relative/Visitor comment cards returned to the inspector provided further evidence that most people had access to and have been made aware of the complaints procedure. Knights Grove Nursing Home DS0000067659.V319111.R01.S.doc Version 5.2 Page 15 Staff have received training in the protection of vulnerable adults and the inspector found the staff he interviewed to be confident in their approach to supporting service users and reporting any concerns about their care. Staff were aware of how to report concerns about the conduct of colleagues under the organisations “whistle-blowing” policy. Staff also told the inspector that other training courses and forums that they have attended have linked in to issues about supporting service users including a dementia forum group, which covered issues on elder abuse. Knights Grove Nursing Home DS0000067659.V319111.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 24 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are provided with an environment that is clean, comfortable and spacious and each service user has a bedroom that have been arranged to meet their needs. EVIDENCE: The inspector toured the home with the assistance of a member of staff. The home is spacious with a number of rooms over the three floors that can be used by service users. During the visit the inspector had the opportunity to view a number of service users rooms and these were clean and in a good state of repair. Most rooms had been furnished with personal items and belongings and all rooms have an en-suite facility. Knights Grove Nursing Home DS0000067659.V319111.R01.S.doc Version 5.2 Page 17 A number of additional features have been built into the environment to assist with keeping service users orientated in the home. Colour coded doors and handrails. Additional lighting and large door signs have been installed to assist service users. The home is bright and the décor is homely for a large home. Furniture and fixtures in communal areas is of good quality and service users looked comfortable and relaxed in their surroundings. A garden and patio area is accessed from the lounge and this is securely fenced as the surrounding areas have ongoing construction work taking place. The manager told the inspector that planting and screening work is taking place to provide more privacy to service users using the garden. Keypad entry systems are installed in areas that are not accessible to service users and have a high risk. This includes access to stairwells and lifts. The manager was advised to include these restrictions within a risk assessment to demonstrate a need for such restrictions. The manager discussed how they are planning to carry out further work on the facilities in the home including the improvement of the first and second floor lounges and the storage facilities in the home. Service users take their meals in these areas and the inspector observed individuals using tray tables to have their meal. The manager wants to ensure that this is improved and additional work will start soon, which includes the development of additional galley kitchens and better facilities in the lounges on these floors. The home was clean and tidy and free from any unpleasant smells. The laundry room was examined and this was clean with facilities for laundering and drying. The inspector observed staff members adhering to good practice when moving soiled laundry including the use of dissolvable bags. Aprons and gloves were seen in use in the home and hand-washing facilities are available in the laundry. Sluice facilities are in place on each floor. Knights Grove Nursing Home DS0000067659.V319111.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported by a staff team that are well trained and supervised enhanced by recruitment practices that are robust and protect service users. EVIDENCE: The home provided a rota to confirm that sufficient staff are on duty throughout the day to meet the needs of service users. Trained nurses are available on each floor during the day. A National Vocational Qualification (NVQ) programme is in operation in the home and records indicated that staff are being supported to achieve this award. Currently 12 of the staff team have an NVQ 2 or above with some staff currently working on this award or booked to start at a future date. Staff told the inspector that they have also attended training on Alzheimer’s disease and have completed a learning portfolio. An induction programme is in place to train and develop staff. The inspector noted a training session in first aid was taking place in the home during his visit. The manager told the Knights Grove Nursing Home DS0000067659.V319111.R01.S.doc Version 5.2 Page 19 inspector that one day a week is allocated to providing training for staff to ensure everyone has completed their training portfolio. Staff members stated that they felt very well supported by their colleagues and the manager of the home. The inspector examined staff training profiles and these included a record of training attended and certificates to support this record. Records demonstrated that staff have attended all mandatory training including Food Hygiene, First Aid, Health and Safety and Moving and Handling. Five staff files were examined and found to have appropriate application forms, two or three written references, proof of identity and a completed Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) check. One staff file was missing a reference and the manager undertook to address this when identified by the inspector. A new tracking system has been introduced by the home to monitor and coordinate local personnel records to avoid problems in the future. A supervision programme has been established in the home and staff members are receiving regular support with a documented record of these sessions. Staff meetings take place and regular senior staff meetings are also held. Knights Grove Nursing Home DS0000067659.V319111.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported by a service, which is managed in an effective and open manner. The home is developing systems to ensure service users views are acknowledged and used as part of the development of the service. EVIDENCE: The manager is a first level registered nurse and has significant experience as a manger of a registered service. Staff made positive comments about the Knights Grove Nursing Home DS0000067659.V319111.R01.S.doc Version 5.2 Page 21 level of support they receive from the manager and that they found the management of the home to be open and approachable. The home is developing a system to be used in the service to involve service users and their families in developing the home. A member of staff who has a keen interest and experience in this area has been given this responsibility and this was confirmed in discussion with the manager and the member of staff. Regulation 26 visits take place each month and a quality audit is carried out as part of these visits. The manager told the inspector that the organisation also contact people directly to obtain their views on the service. The inspector also noted a suggestion box in the foyer of the home. The impact of the plans on developing a quality assurance programme will be reviewed at future inspections of the service. Some monies are deposited with the home to be used for everyday expenses such as newspapers, hairdressing and personal items. The administrator has a detailed accounting record of these monies and all transactions are checked and receipts are maintained. A small float is held in the home and the balance of this money is held in a bank account that is only used for Knight’s Grove resident’s money. Interest is calculated and distributed proportionately to service users. The inspector spoke to the person responsible for day-to-day maintenance and up-keep of the home. They provided records to demonstrate that fire checks and tests are carried out regularly. Fire drills and practice are carried out on a regular programme. The home was in a very good state of repair and the inspector was informed about the regular inspection of the building and checks of equipment and devices in the home. Knights Grove Nursing Home DS0000067659.V319111.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Knights Grove Nursing Home DS0000067659.V319111.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? N/A STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Knights Grove Nursing Home DS0000067659.V319111.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Knights Grove Nursing Home DS0000067659.V319111.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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